CMS Formulary

Displaying 127531-127540 of 1611142 results.
ID: 127531
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127532
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127533
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127534
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127535
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127536
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127537
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127538
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127539
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127540
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0